Esophageal Varices

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Esophageal varices (or oesophageal varices) are extremely dilated sub-mucosal veins in the lower third of the esophagus. They are most often a consequence of portal hypertension, commonly due to cirrhosis; patients with esophageal varices have a strong tendency to develop bleeding. Symptoms: Black, tarry stools. Bloody stools. Light-headedness. Paleness. Symptoms of chronic liver disease. Vomiting. Vomiting blood.

Treament: Bleeding will recur in most people who have bleeding from esophageal varices. Beta blockers and esophageal band ligation are the recommended treatments to help prevent rebleeding. Emergency treatment for bleeding esophageal varices begins with blood and fluids given intravenously (into a vein) to compensate for blood loss. At the same time, intravenous drugs may be given to decrease blood flow to the intestine. Efforts are then made to stop the bleeding. Endoscopy is done to identify the site of the bleeding. Band ligation. A rubber band is used to tie off the bleeding portion of the vein. Sclerotherapy. A drug is injected into the bleeding vein, causing it to constrict (narrow). This slows the bleeding and allows a blood clot to form over the ruptured vessel.

Epidemology: Up to 80% of patients with liver cirrhosis develop esophageal variceal bleeding which is lethal in up to 30% after the first bleeding episode. Parameters suitable to identify patients being on risk to bleed from their varices are severe liver disease.